Valvular heart disease, either of congenital or acquired origin, may be sufficiently severe to require surgical intervention. With an increase in understanding of valvular disease, there has been a decrease in morbidity and mortality for patients requiring valve replacement. However, as long-term survival has increased, problems related to artificial valve thromboembolism, anticoagulation, valve induced hemolysis, and, more recently, fibrocalcific changes in bioprosthetic valves have become apparent.